PAs’ Role in Helping to Administer Medication

This guidance is based on that given by Care Inspectorate, Royal Pharmaceutical Society of Scotland and Social Work Scotland in ‘Prompting, assisting and administration of medication in a care setting: guidance for professionals.’ The full document can be accessed below in resources.

If a Personal Assistant (PA) is required to help with medication, this should be clearly documented in the support plan agreed between the supported person, employer (if this is someone different) and their local authority.

Decisions on the support required around medication should be made, wherever possible, by the person who needs to take the medication. Sometimes, they will need the assistance of others to help with the decisions and these people may include their carer, their guardian or a health professional.

Prompting, assisting and administration of medicine

There are different levels of support a person may require from their PA to help them with their medication:

• Prompting
• Assistance
• Administering.

Prompting

This is when the PA reminds the person about their medication. It may be to alert them to the time so that the person can choose whether or not to take their medication. The person is in full of control about the choice they make about taking their medication. The PA offers no further advice or intervention.

Assistance

The person remains in control of their medication but requires the help of their PA with mechanical tasks, for example:

• Ordering and collecting repeat prescriptions
• Making packs of medication available to the person eg. passing the pack to the person
• Opening bottles or packets of medication including multi-compartmental compliance aids (eg. dosette boxes)
• Reading the label on the medication to the person
• Making a drink available to the person to take with their medication.

Administration

When a person cannot take responsibility for managing their medication, the PA may be responsible for ensuring that the person gets offered or is given the correct medication, at the correct time, in the correct way.

Administration of medication involves the PA doing the one or a combination of the following:

• Deciding which medicine(s) have to be taken or applied and when this should be done
• Being responsible for selecting the medicines
• Giving a person medicines to swallow, apply or inhale, where the person receiving them does not have the capacity to know what the medicine is for, or identify it
• Giving medicines (even at the request of the person receiving care) where a degree of skill is required to be exercised by the PA to ensure it is given in the correct way
• Following instructions on the container when administering medication.

Medicines not routinely given by PAs

This includes giving medicines via an ‘invasive’ technique, for example:

• Via the rectum eg. suppositories
• Insulin via injection
• Via Percutaneous Endoscopic Gastrostomy (PEG) tubes.

PAs can be trained by an appropriate health professional to administer medication via invasive routes.

The person being supported (or someone who makes decisions on their behalf, if they do not have capacity), can decide whether they consent to the PA providing this treatment.

If administering medication via invasive routes is required as part of a PA’s job, this needs to be clearly explained in the job description and the PA needs to be in agreement with carrying out this role.

When something goes wrong

The PA must follow appropriate action in the event of the person reacting badly to their medication. This might include seeking medical advice (eg. calling 999 if the reaction appears to be life threatening). The PA must record such incidences and advise their employer of them at the earliest opportunity.

Should the PA make an error with assisting or administering medication, the above steps must also be taken.

Training and good practice

PAs must be trained to prompt, assist or administer medication. Local independent support services and Local Authorities should be able to advise on appropriate training.

PAs must liaise with their employer, and health and social work professionals, to ensure good practice is adhered to.

Employers should ensure their insurance provider is aware of the requirement for the Personal Assistant to provide assistance with or administer medication.

Employers should work with their Local Authority to ensure appropriate paperwork is in place to record the administration of medication.

Next steps

Take a look at the additional resource below on prompting, assisting and administration of medicines.